copyright  ©1980 by  William H. Calvin and  George A. Ojemann

PREFACE To know one's self is in essence to know one's brain -- to probe such issues as consciousness, creativity, intelligence. It has been said that the brain, understanding itself, remains mankind's supreme challenge. This book is a progress report of sorts. It is hardly comprehensive; in particular, it does not cover many aspects of psychology. The title of this book can be taken literally: we hope to acquaint the reader with what is inside the brain and convey a sense of how it works. Mapping the cerebral cortex has yielded a great deal of information about how some parts of the brain have developed specialized areas during evolution: not merely the maps of the sensory worlds, but the locations of those parts of the brain which give us our language abilities, our ability to direct our attention, our ability for music, and our ability to read this. Yet locating the head office for such abilities does little to reveal how the individual nerve cells bring off these feats. Exploring the neuron (a nerve cell by another name) shows how information is processed by electrical and chemical means, how circuits of neurons are wired together to perform more elaborate tasks, such as telling vertical from horizontal. Each neuron by itself turns out to be an elaborate computerlike machine. With many of them working together, complicated patterns can be analyzed and decisions made. Despite one of its major themes, this book is not really about neurosurgery. As generations of physiologists have known, one of the best ways to illustrate normal function is to show how things go wrong. Epilepsy, strokes, and tumors have all contributed much to our knowledge of "what's where" in the brain. During operations on epileptics to control seizures, electrical stimulation of very local areas of brain can be performed. This "mapping" has provided science with some of the most detailed knowledge about how the different regions of the brain specialize. In this book, we follow an epileptic, Nell, through such a day of neurosurgery and science. We discuss other diseases of the brain in the process of illustrating how neurons work. Thus we are not setting out to survey the scientific knowledge of schizophrenia or Parkinson's disease; rather, we are seeking to illustrate how normal aspects of neurons can go wrong. That we manage to cover quite a number of diseases in this manner reflects the extent to which the scientific quest for fundamental knowledge has proved broadly useful in illuminating disease mechanisms. Our nonscientist students have convinced us that many aspects of brain research can be digested by the general public. We have been teaching a noncredit course about the brain and have found that there are many areas of neuroscience which can be presented in considerable detail without running into technical barriers requiring preparation in physics or chemistry. We would like to thank our many "students" who contributed suggestions and encouragement. Through them we have gained an appreciation for the varied motivations, backgrounds, and expectations of general readers. This book, however, is not a textbook for such a course. A textbook writer sets out to convey a certain body of information in a well-organized and accurate manner, usually without the emphasis and comment characteristic of science journalists. One simply assumes that the reader will be impressed by the facts, once they are properly digested; however, one can also assume the presence of a teacher to maintain continuity and that students will reread and study the material. A general reader who tries to get through such a textbook has to be quite disciplined to get beyond the second chapter. As science journalists know, it is not merely a problem of translating technical material into more accessible language: there will always remain some hurdles, different for different readers, and one must motivate the unaided reader over them. Our device to maintain continuity is "Neil": thanks to our familiarity with the neurosurgical operation for epilepsy, we were able to create a central event and a main character, which we periodically revisit. We have also intentionally postponed (at the expense of a more logical organization) some of the more technical material until after the reader has had a chance to, become familiar with the general flow of the story. We hope that when we are telling readers more than they really wanted to know about a certain subject, they will understand that they can simply skip ahead to the more familiar material at the beginning of the next chapter. We have tried to make most chapters capable of standing alone. Every field of endeavor has its own specialized vocabulary, and neuroscience is no exception. First-year medical and graduate students spend months learning all of the names. This can be one of the pleasures: one book reviewer said of a science journalist that he "is captivated by the terminology of high energy physics and obviously enjoys the mystery and incomprehensibility of it all."' Our effort to avoid terminology for its own sake, while resulting in a more compact book, does lead to some curious omissions: we have discovered that our manuscript does not mention the corpus callosum, as we approached lateralization of function to left and right sides using evidence other than the popularized split-brain studies. It is sometimes difficult to get behind the facade of facts, but science has its other pleasures. As one science journalist noted, "I value physics, not for how well it explains the world, but much as the irreligious loved the Latin mass, for how it sounds." Although they seldom talk of such things in print, neuroscientists are excited about the picture of the brain which emerges from their collective research. Sometimes they are impressed in the manner of the Latin mass: it is important how it sounds, how "elegant" it is (contemplating science can be like listening to Bach). Sometimes they are excited by the potential applicability of the knowledge. And often, neuroscientists are intrigued because their findings help them to understand their own personal experiences. What this book seeks to accomplish is to convey the sense of adventure felt by those engaged in exploring the brain, to show how human intelligence arises out of the varied specializations of the brain, and to demonstrate that these specialized regions are composed of millions of individual neurons whose electrical and chemical properties can be analyzed and understood by neuroscientists. Our present understanding is quite imperfect, and we have also tried to show some of the dilemmas which this poses in the medical and surgical care of those with brain disorders. Unfortunately, not all patients with neurological illnesses recover as well as those we have chosen to illustrate. Most of the people in this book, whether patients or doctors, are really composites of a number of people whom we have known. Where a case history does represent a single person, the name has been changed. An exception to this is Fred, the patient who awoke one morning to discover that he had lost his ability to read, although his vision was other-wise perfect. He is Fred H. Calvin, the father of one of the authors, and he provides a good example of how patients can recover functions lost following a stroke: he is one of several dozen nonscientists whom we must thank for reading earlier versions of our manuscript. Susan M. Johnston edited numerous drafts and coordinated us all; her forthright judgment and sense of style have been greatly appreciated.  Phyllis Wood cheerfully illustrated the book for us. At this juncture, it is customary to thank spouses and children for their forebearance during the ordeal of book writing. That they have all survived our preoccupation without noticeable harm may reflect the fact that much of the writing was done in airplanes and airports. As our wives are also neuroscientists on the University of Washington faculty, we have gotten much help from them. Dr. Linda Moretti Ojemann contributed some choice case histories from her neurology experience. Dr. Katherine Graubard alternated neurophysiological criticism with enthusiastic encouragement. Together, they provided one piece of advice that was especially valuable. As we all sat around after a memorable Thanksgiving dinner, they spent hours persuading us to abandon our previous textbook-style draft of this book (which was two years in the making) and to start all over again, using lots of dialogue and case histories instead. Taking their advice has immeasurably improved the book and spared readers many hardships. We thank them. Seattle

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Continue to CHAPTER 1 Notes and References for this preface   Book's Table of Contents   Copyright ©1980 by William H. Calvin and George A. Ojemann Email Calvin  ||  Email Ojemann  || Calvin Home Page

Inside the Brain (NAL, 1980; Authors Guild reprint 2001), co-authored with my neurosurgeon colleague, George Ojemann, is back in print. Note that it was effectively replaced by our Conversations with Neil's Brain. except that space limitations caused us to omit the subcortical aspects which are prominent in Inside the Brain.  The Authors Guild reprint edition is available through amazon.com and other booksellers.